Florida tackles concerns about disabled children in nursing homes

Tallahassee, Florida - State health leaders are going on the offensive to counter a critical federal report accusing Florida of warehousing more than 200 severely disabled children in nursing homes.

The U.S. Department of Justice has threatened to sue the state over the practice of placing medically fragile children in nursing homes. The department alleged the children were not getting appropriate care.

Florida Surgeon General John Armstrong, Department of Children and Families Secretary David Wilkins and Agency for Health Care Administration director Liz Dudek announced Thursday that Florida is taking action to improve care for the children.

The state has launched, what it calls, an enhanced nurse care coordination program. It's designed to pair up a nurse advocate with parents of disabled children to make sure they're getting the best possible medical care.

The nurses will also help parents bring their children home from nursing homes when it's medically possible.

Dudek said she visited the six nursing facilities in Florida that care for disabled children.

Dudek said contrary to what the Department of Justice documented, she found conditions were good - facilities had special activities for the children, rooms were personalized for a child, kids had "buddies" and they went out to school where they could.

"I have to wonder what the Department of Justice was looking at when they went through there and would invite any of you to go to any of those facilities because I certainly did not see what they were seeing."

Florida had placed as many as 287 disabled children in nursing homes at one point, but Dudek says that number has now dropped to about 220.

Wilkins said DCF had as many as 35 foster children in nursing homes but has reduced that number to around 20. He said half of those children must be in a nursing facility because of the extent of their disabilities.

"We do not want to have situations where children are having to be housed in skilled nursing facilities. So we need to make sure everybody understands that."

Wilkins said Florida needs more people to step up to serve as medical foster parents. That requires special training.

"We have a call-out for those medical foster parents today. We need one in Pensacola. We need one in Naples. We need five in Tampa. We need four in Broward and a couple in Palm Beach."

Surgeon General Dr. John Armstrong said the Department of Health is bringing together the families of medically fragile children with teams of health service professionals. It's called a Children's Multidisciplinary Assessment Team, or CMAT.

Armstrong said the team works to find the best setting for a disabled child, emphasizing the least restrictive setting. He said parents or guardians are members of the CMAT to help determine the most appropriate location to live.

Armstrong said his department has changed its protocol to help make sure these children are living in the right spot over time.

"Until last month, the Department of Health required at least an annual CMAT review. Now the department holds CMAT evaluations at least every six months for our medically fragile children who reside in skilled nursing facilities. This will ensure the most appropriate health care setting is in place over time."

Armstrong said 10 CMAT teams served more than 1,100 children in Florida last year and added that they will constantly reassess a child's needs.

Dudek says Florida continues to talk with the Department of Justice about its concerns, but insists she has not seen any evidence to substantiate those concerns.